MiHomecare - Finchley

Updated 13 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25, 26 and 27 June 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to ensure that the someone would be present to support the inspection. The inspection was carried out by three adult social care inspectors, a pharmacist inspector who reviewed people’s medicines records and four experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts by experience supported this inspection by carrying out telephone calls to people and their relatives.

Before the inspection we looked at information that we had received about the service and formal notifications that the service had sent to the CQC. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. This included information around safe medicines management, personal risk assessments for people using the service and overall quality and monitoring of the service.

We used information the provider sent to us on 11 May 2018 in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we looked at 17 people’s care records and risk assessments, 14 staff files, 17 medicines records and other documentation related to the management of the service. We spoke with the deputy manager, the operations director, the head of quality, the quality manager, the director of the company and 17 care staff. We also spoke with 15 people that used the service and 15 relatives. Following the inspection, we spoke with the registered manager.

Updated 13 October 2018

This inspection took place on 25, 26 and 27 June 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service. It provides personal care to people living in their own houses and flats. It provides a service primarily to older adults and people with physical disabilities.

Not everyone using MiHomecare – Finchley receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection MiHomecare - Finchley provided domiciliary care and support for 456 people in their own home. Following the inspection, the deputy manager informed us that 381 people received a regulated activity.

At our last inspection on 4 and 11 May 2017 the service was rated ‘Requires Improvement’. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12 which related to the safe management of medicines and providing sufficient information on people’s personal risks to ensure that staff were able to minimise the risk and Regulation 17 which related to monitoring and auditing people’s medicines and daily care records. At this inspection we found that the provider had addressed these breaches.

We also made a recommendation around capturing and documenting information on the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) in relation to people using the service. At this inspection we found that the service had addressed this and MCA/DoLS was well documented and managed.

The service is now rated ‘Good’.

There was a manager in post. However, at the time of the inspection the manager was on planned leave. The manager was in the process of applying to CQC to become the registered manager and was registered on 17 July 2018. The inspection was supported by the deputy manager. A registered manger is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of law; as does the provider.

People and relatives were positive and felt that they were safe with the staff that visited to provide care.

People had person centred risk assessments based on their individual needs. Risk assessments were detailed and provided staff with guidance on how to minimise known risks.

Staff had received training in safeguarding and understood how to recognise and report any concerns. The company had a dedicated whistleblowing phone number for staff, relatives and people. Staff understood how to whistleblow if they had any concerns.

Medicines were safely managed. Staff had received training in medicines and were competency assessed each year. Medicines auditing was effective and had improved since the last inspection.

Staff were recruited safely. The service completed necessary checks to ensure that staff were safe to work with vulnerable adults.

Staff were aware of infection control and how to keep people safe from the spread of infection. The service provided gloves and aprons for staff when delivering personal care.

People received continuity of care and often had the same care staff visiting them. People and relatives told us that staff were on-time and stayed the correct amount of time.

Accidents and incidents were well managed and any actions or learning documented.

Staff received an induction when starting work. Part of the induction included shadowing more experienced staff. However, whilst staff told us they did shadow during their induction this was not well documented.

Staff received regular supervision, appraisal and training to support them in their role.

People were supported to express their views and were actively involved in making decisions about their care. Where appropriate, relatives had been involved in planning people’s care.

People were supported with their nutrition and hydration where this was an identified need. People were positive about the support they received with meals.

Staff were aware of how to report concerns if they noticed a change in people’s health or well-being. People were referred to healthcare professionals where appropriate.

There was a complaints process in place and people and their relatives knew how to make a complaint. Complaints were investigated and followed up.

People and relatives told us that they felt that staff were kind, caring and treated people with compassion and empathy. Staff understood the importance of communication and building rapport with people and their relatives.

People were encouraged to be as independent as possible.

Staff knew people well and people told us that they were treated with dignity and respect.

People and where appropriate, their relatives were involved in planning their care. This was well-documented in people’s care plans.

Care plans were detailed and provided enough information for staff to support people. Care plans were regularly reviewed and updated immediately if changes occurred.

Audits were carried out across the service on a regular basis that looked at things like, medicines management, health and safety and the quality of care. Surveys were completed with people who used the service and their relatives. Where issues or concerns were identified, the manager used this as an opportunity for change to improve care for people.